Health Insurance Exam

10%

A "premature" distribution from a modified endowment contract (MEC) incurs a penalty tax of

premiums which can only be increased per rate class

A guaranteed Renewable provision allows

within 15 days of receipt of the notice of loss

A health insurer MUST provide a proof of loss from

30 days

A license MUST notify the Commissioner of an address change within ____ days of the change.

providing referrals

A license is NOT required when you are

Appointment

_____ is the authority given to a producer to sell, solicit, or negotiate polices on behalf of the insurer.

Credit

_______ life insurance is designed to pay the balance of a loan if the insured dies before the loan has been repaid.

nonresident producer

a producer who is licensed in Oklahoma but resident in another is called a

Policy Delivery

a signed good health statement may be requested by a life producer at the time of

Consideration clause

an accident and health insurance policy's premium requirements are set forth in which of the following provisions.

the policy owner can make policy changes without difficulty

an advantage of owning a flexible premium life insurance policy would be

Fraud

an applicant for health insurance deliberately lies in order to obtain a lower premium rate. this is an example of

root canal

an example of endodontic treatment is a

Accelerated Benefits

proceeds payable under a life insurance contract to a policy owner in anticipation of death are called

excluded from the employee's gross income

Employer-paid qualified long-term care insurance premiums are typically

replacing an insurance policy from one insurer to another based on misrepresentation

Twisting is

the policy owner may need to resume premium payments depending on actual results.

A life insurance illustration showing future premiums being paid out of non guaranteed values must disclose that

2 years

A life insurance policy becomes incontestable after it has been in force for

insured is expected to be continued to a nursing home for life

A life insurance policy that contains an accelerated benefit rider will provide funds if the

relieve the insured of premium payments following an initial waiting period after the insured becomes totally disabled.

A life insurance policy's waiver of premium rider has the ability to

2

A medical expense health plan claim may be denied due to material misrepresentation within _____ years of issue.

$16,000 was received tax-free and $4,000 as ordinary income.

A nonparticipating whole life insurance policy was surrendered for its $20,000 cash value. The total premiums paid had totaled $16,000. What were the federal income tax consequences to the policy owner on receipt of the cash value?

In the event of death, the loan amount is deducted from the policy proceeds

A policy owner has just borrowed from a life insurance policy's cash value. Which of these statements is true?

Beneficiary receives $50,000 income taxes

A policy owner pays the first annual premium for a $50,000 life insurance policy and dies one month later after the policy effective date. Which of these statements is normally true?

Partial Disability

A policy owner suffers an injury that renders him incapable of performing one or more important job duties. Any decrease in income resulting from this jury would make him eligible for benefits under which provision?

Misappropriation

A producer may be disciplined by the Commissioner for which of the following actions?

2 years

A producer's license MUST be renewed every ____ years.

50 employees

A small employer in Oklahoma may NOT consist of more than ______ eligible employees.

180 days

A temporary producer licensed issued in Oklahoma is valid for up to ____ days.

a false statement could lead to loss of coverage

After an applicant reads and signs an insurance application, he/she should be conscious of the fact that

January through March of each year

After the initial enrollment period for medicare Part B has expired, when may an individual purchase again?

bringing legal action against the insurer

An accident and health insurer has just received written proof of loss form one of its insured. the insured must now wait 60 days before

HMO Plan

An accident and health plan that typically covers ONLY the services of approved providers is called a

is an insurer on risks located only outside of Oklahoma

An alien insurer

Applicant has the right to receive a copy of the report

An applicant submits a life insurance application where an investigative consumer report is used in the underwriting process. Which of these statements is true?

Misrepresenting policy provisions affecting a loss

An example of an Unfair Claims Settlement Practice is

living in a rural area

An insurance policy may be issued with a preferred insurance premium in all of these situations EXCEPT

variable life

An insurance policy that can also be classified as a securities product is called

$300

An insured files for an accident and health insurance policy claim 8 days after the premium due date. The benefit payable is $500 and the overdue premium is $200. Assuming that the policy pays on a first-dollar basis and contains the unpaid premium provision, how much will the insurer pay?

notify the insurance company in writing

An insured is covered with a. health insurance policy. If the insured would like to cancel the policy, he/she must

30 days

An insured previously covered under a private health insurance plan must notify the insurer with ______ days of deactivation from the military in order to reinstate the coverage.

covered with term life insurance

Any employee insured under a group life insurance plan is normally

When the first insured dies

At what point are death proceeds pain in a joint life insurance policy?

Rebating

Barry offers Chris his mountain cabin for the weekend to secure his order for his insurance business. This is an example of

Guaranteed insurability rider

Bryce purchased a disability income policy with a rider that guarantees him the option of purchasing additional amounts of coverage at predetermined times without requiring to provide evidence of insurability. what kind of rider is this?

Unfair Discrimination

Charging different rates between individuals of the same class and equal expectation fo life is best described as:

active military duty

Disability income insurance normally excludes coverage for disabilities that arise from

unfair claim settlement practice

Failing to promptly provide a reasonable explanation for the denial of a claim is considered to be an

Exempt from income taxes

How are benefits payments from individually-owned medical expenses polices treated for tax purposes?

the unpaid premium maybe subtracted from the reimbursement

How is an insured's accident and health claim handled by an insurer if it occurs during the policy's grace period?

premiums payments are waived in the event the premium payer dies or becomes disabled.

How is the insured protected if a payor benefit rider is attached to the life insurance policy?

3 years

How long must a life insurance policy be in effect before the policy owner may use the nonforfeiture provision?

every 5 years

How often must the Commissioner examine domestic insurance company?

60 days

If an employee loses employment, how long does the employee have to apply for COBRA?

Social Security Administration

If an individual would like to enroll in Medicare or seek public information about Medicare, which federal agency handles this?

8%

In Oklahoma, a life insurance policy loan may NOT exceed an interest rate of

15

In Oklahoma, the minimum age that a person may contract for life and health insurance is _____ years old.

in-house pharmacy

In a staff model HMO, enrollees normally have which of the following pharmacy options available to them?

applicant must be enrolled in a High Deductible Health Plan

In oder to contribute to a Health Savings Account

be offered the same group health benefits offered to the younger employees

In regards to health insurance, employees age 65 or older are typically required to

31 days

In the event of employment termination, a person covered by a group life policy also has the right to convert such a coverage to an individual policy within _____ days without proving insurability.

generally unlimited

Insurable interest in one's own life is legally considered as

the insurer was not notifed prior to the claim that the insured has other health coverage

James is covered with health insurance by 2 different insurers. The "insurance with other insurers" provision in an individual health insurance policy allows an insurer to pay benefits to the insured on a pro-rata basis when

100%

John received a one-time distribution of $50,000 from his modified endowment contract. Prior to that, the contract's cash value was $150,000, the contract investment amount was $100,000 and the death benefit was $500,000. What percentage of the $50,000 distribution was taxable as ordinary income?

The date the agent delivered the policy, collected the initial premium, and obtained a good health statement from the insured.

K is an agent who takes an application for individual life insurance and accepts a check from the client. he submits the application and check to the insurance company, however the check was never signed by the applicant. if the application is approved, when will coverage be effective?

specific reasons stated in the contract

Kelly purchases a health insurance policy issued on a conditionally renewable basis. The insurance company has a right to refuse renewal of the policy for

Plan A pays up to $5,000 and Plan B pays up to $2,000

Kim is covered under two medical expense plans. Plan A pays up to $5,000. Plan B pays up to $4,000. if she incurs $7,000 in expenses, the coordination of benefits provisions dictates that

Level Term

Laura added a children's rider to her life insurance policy. what type fo coverage was added?

Custodial care

Major medial plans typically exclude coverage for which of the following benefits?

Skilled nursing facility care

Medicare Part A covers which type of care?

inpatient drugs

Medicare Part A typically covers

Medicare Supplement insurance

Medicare Part B excess charges are covered by

date of issuance of the conditional receipt

Mike applied for life insurance and was issued a conditional receipt. He is later found to be insurable and is issued a policy. when does his coverage become effective?

oral examinations

Most prepaid dental plans cover

Reduce the benefit level

Omar is covered by a disability income policy. He is hurt while performing an occupation more hazardous than the occupation listed in his policy. The policy's change of occupation provision will have what effect?

by certified mail

On issuance of an emergency cease and desist, how must the Commissioner deliver notice to the person affected?

the gain is treated as taxable income and a penalty tax is imposed on the gain

Peter, age 50, surrenders his modified endownment contract. How is the gain treated in terms of federal income taxes?

24

Producers must complete ____ hours of continuing education biannually

Medicare

Skilled nursing facility expenses are sometimes covered by_____ but ONLY if the insured was hospitalized prior to entering the facility.

Section 1035 rules

Switching Life Insurance policies without tax consequences is permitted under

Flexible Savings Account (FSA)

The "Use it or Lose it" rule applies to

Benefits can be increased in the event of a covered claim

The Change of Occupation provision in a disability income policy states that, in event the insured changes to a less hazardous occupation, which of the following may apply?

COBRA representatives

The Insurance Information and Privacy Protection Act is designed to limit or direct the information collection activities of all the following EXCEPT

enters the hospital

The benefit period of Medicare Part A begins on the first day the insured

lender

The death proceeds of a credit life insurance policy are typically paid to the

the amount of an annuity payment subject to income tax

The exclusion rate determines

It is typically obtained by the producer and forward to the insurer

The initial premium for a life insurance policy is typically paid in what way?

The first premium payment and the application

The insured's consideration for a health insurance policy is

policy loans are not permitted

These are all accurate statement regarding universal life insurance EXCEPT

long- term care benefit rider

Tim is confined to a nursing home by doesn't have a terminal illness. Which life insurance rider is designed to help pay for this type of expense?

Noncancellable

Tim is covered by an accident and health insurance policy that may not be changed in any way by the insurer up to a stated age, as long as the premium are paid. what type of policy is this?

63 days

Under HIPAA requieres guarantee issue of insurance as long as there has not been more than a _____ day gap in coverage.

24 months

Under the Unfair Claim Settlement Practices, an insurer may recoup overpaid claims within ______ months after payment was made.

When not prohibited by state law

Under what circumstances does an accident and health insurer have the right to request an autopsy?

65

Upon reaching age _____, Medicare supplement coverage is offered on a guaranteed-issue basis during the open enrollment period.

Reduces the amount receivable upon surrender the contract

What could be the potential result of taking out a cash value loan under a life insurance policy?

Reduced death benefit

What effect can a long-term care benefit rider have on a life insurance policy?

Decreases premium

What effect does interest income have upon insurance premiums?

the policy proceeds would be reduced by the outstanding loan balance

What happens when a policy owner borrows against the cash value of his life insurance policy?

a life policy that coves the life of a minor

What is a juvenile life insurance policy?

Minors are normally not capable of handling money in a reasonable manner

What is considered a valid reason for an insurer's refusal to pay policy proceeds directly to a minor?

cash value

What is payable to the policy owner if a whole life policy is surrendered prior to its maturity date?

Guaranteed Insurability Rider

What is the name of the rider that provides an additional purchase option in a life insurance policy?

Conditional disclosure

What must be given to a life insurance applicant when the agent receives an application and the initial premium?

reinstated

When a lapsed policy's premium has been paid current, it has the optional of being

An immediate annuity

When a large sum of money is used to structure monthly payments, which product is typically used?

Producer

When a producer submits an application that discloses personal information regarding the applicant, who supplies the privacy notice?

Ten year term insurance for a person aged 55

When a ten year renewable term life insurance policy issued at age 45 is renewed, the premium rate will be the current rate for

Insuring

Which health policy clause specifies the amount of benefits to be paid?

Annual increases in premium for a stated number of years then remains level

Which is an accurate description of the premium in a graded premium life insurance policy?

Free-look period

Which life insurance policy provisions allows a policy owner to cancel the policy and receive a full refund within a limited time period after policy delivery?

Whole Life

Which life insurance policy would be eligible to include an automatic premium loan provision?

Fixed amount installment option

Which life insurance settlement option pays a stated monthly benefit unit both principal and interest are exhausted?

Misdemeanor Conviction

Which of the following actions by a producer would NOT result in a license suspension or revocation?

A flexible premium deposit fund and a monthly renewable term insurance policy

Which of the following combinations best describe a universal life insurance policy?

A Medicare Supplement core benefit

Which of the following describes coverage for the Medicare Part B coinsurance?

Small co-pay per visit or per service

Which of the following does a Medicare Advantage enrollee typically pay for?

Treatment in a government facility

Which of the following does medical expense insurance NOT typically cover?

Noncancelable

Which of the following health insurance plans charges a premium that cannot be increased?

Entire Contract clause

Which of the following health insurance provisions requires that the application becomes part of the policy?

High school diploma

Which of the following is NOT a qualification to be licensed as a producer?

An annuity exchanged for a life insurance

Which of the following is NOT a valid contract exchange?

The policy will be issued regardless of health

Which of the following is a true statement regarding a Medicare Supplement policy purchased during the open enrollment period?

Fraternal

Which of the following is an nonprofit entity operating under a lodge system?

Custodial facility care

Which of the following long-term care benefits would NOT encourage home health care?

After a stated period of time, claims cannot be denied due to material misrepresentation on the application.

Which of the following statements accurately describes the "time limit on certain defenses'?

May be worse than the financial impact of death

Which of the following statements accurately describes the financial impact of total disability?

Group health coverage is NOT available for workers over the age of 65

Which of the following statements is NOT true concerning the relationship between group health insurance plans and Medicare? (assuming the business has more than 20 employees)

Life income annuity

Which of these is NOT a common life insurance nonforfeiture option?

Determining the final rate classification

Which of these is NOT an underwriting responsibility of a life insurance agent?

Decreasing term life

Which of these life insurance policies does NOT contain a cash value provision?

policy can alternate between forms of term and whole life insuracne

Which of these statements accurately portrays an adjustable life insurance policy?

Interest payments made by policy owner are deductible

Which of these statements is NOT true regarding a cash value loan against a life insurance policy?

It allows a policy loan to cover premium payments if the policy owner becomes totally disabled.

Which of these would NOTN be a valid reason to add the waiver of premium rider to a life insurance policy?

Consumer report

Which report contains information regarding an individual's general reputation and credit standing?

The face amount and premiums can be charged simultaneously by the policy owner

Which statement concerting adjustable life insurance is accurate?

The agent doesn't have the authority to change the policy or waive its provisions

Which statement concerting the Entire Contract provision is an individual accident and health insurance policy is TRUE?

Coverage excludes nonoccupational injuries

Which statement is true about a permanent disability under workers compensation coverage?

Insurance coverage can continue for life

Which statement regarding whole life insurance is accurate?

Disability income

Which type of group is excluded from HIPPA rules?

An individual permanent life insurance policy

Which type of policy can group term life insurance normally be converted to?

Insurance company

Who is protected with the "other insurance with this insurer" provision?

Insurer

Who is required to notify the producer in the event of appointment termination?

The insurer or the insured

Who may terminate coverage under a cancelable health insurance policy?

Borrower

Who normally pays the premiums for group credit life insurance?

the policy's cash value

what is considered the collateral on a life insurance policy loan?

50 employees

what is the maximum number of employees an employer may have for qualified medical savings account?

Federal payroll and self- employment taxes

where does the primary funding for Medicare Part A come from?

Premium remains the same no matter how many children

which statement regarding the life insurance premium for a children's rider is true?